Until recently, most of us probably viewed measles as an unlikely threat that we’d largely gotten under control thanks to modern science and the MMR (measles, mumps, and rubella) vaccine. In fact, measles was considered eradicated in the U.S. as of the year 2000 due to widespread vaccination.

But now, the U.S. is in the midst of its second-largest outbreak in two decades, according to the Centers for Disease Control and Prevention (CDC). As of this week, there have been 190 confirmed cases in Rockland County, NY, 329 cases in Brooklyn and Queens, and a number of other cases sprinkled throughout states like Michigan, Washington, New Jersey, and California—and it's spreading most rapidly in communities where vaccination rates are low. All told, over 550 people have been diagnosed with measles in 2019 so far.

And with recent headlines like, “Israeli flight attendant in coma after getting measles,” we’re all sort of left scratching or heads wondering WTF? Who’s at highest risk? Can I still get measles if I was vaccinated as a kid?

Here, in an effort to lend some clarity to a confusing and scary situation, we’ve compiled some key answers to your major measles questions and important info on how to tell if you’re protected.

First, what exactly is the measles?

The measles is an infectious disease caused by the rubeola virus—and it’s super freakin' contagious. If someone with measles coughs, sneezes, or even talks, infected droplets of saliva can spray into the air and land on surfaces where they remain active for hours. In fact, about 90 percent of unvaccinated and otherwise susceptible people who come in contact with measles will be infected, says Catherine L. Troisi, Ph.D., associate professor of epidemiology at The University of Texas Health Science Center at Houston School of Public Health.

You may not know you’ve contracted it right away either, making the likelihood that you’ll spread it to others that much greater. Symptoms typically appear about seven to 14 days after a person is infected and initially include a high fever, cough, runny nose, and watery eyes. Eventually, tiny white spots may appear inside the mouth, and then the measles rash breaks out, beginning as flat red spots (that can turn into raised bumps) on the face at the hairline and spreading downward to the rest of the body.

As if that weren’t enough, a number of complications can arise if you contract the measles—yes, even if you’re relatively young and healthy, says Troisi. About 30 percent of reported measles cases having one or more complications such as diarrhea, ear infections, pneumonia, encephalitis, and even seizures. These complications of measles are most common among children younger than five years of age and adults 20 years of age and older.

How can you tell if you're protected?

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1.
If you received two doses of the MMR vaccine as a child...

Currently, the CDC recommends two doses of the MMR vaccine. The first dose is given at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Two doses of MMR vaccine are about 97 percent effective at preventing measles, while one dose is about 93 percent effective. And if you think you can get away with just one, that may not be the case—it’s reported that the flight attendant we mentioned above received just one dose of the measles vaccine as a child.

So, if you and your kids have been vaccinated (with the recommended two doses—or even if your child has only received one dose but is on track to receive their second dose at the appropriate time), you’re most likely going to be protected. Of course, no vaccine gives 100 percent protection. But even if you manage to somehow catch the measles after being vaccinated, you’ll have a less serious case of the virus and be less likely to spread it to others, says Troisi.

2.
If you only received one dose of the MMR vaccine as a child (or if you’re not sure you were vaccinated at all)...

Important to note: The two-dose MMR recommendation was not implemented until 1989. So if you were vaccinated for measles before the guidelines changed, you may not have the level of protection that’s now advised and you should consider asking your doctor for a booster vaccination, says Troisi. This is especially true if you’re an international traveler or if you spend a lot of time in places where there’s a high risk of measles transmission—schools, universities, healthcare facilities, etc. (A booster vaccination is not recommended if you’ve already had two doses.)

If you’re not sure if you were vaccinated and you’d prefer not to have unnecessary vaccinations if you can help it, you can ask your doctor for a measles, mumps, rubella antibody test to see if you have immunity against these viruses. If the test reveals that you don’t have immunity, "Your best bet is to get vaccinated, or if you can’t for medical reasons (e.g. if you’re currently pregnant), stay away from places where you might be exposed," says Troisi.

3.
If you know you've been in contact with someone who has the measles...

If you strongly suspect you’ve been in contact with someone who has the measles, call your doc (even if you know you’ve been vaccinated) for advice on what to do and what symptoms to watch for. If you’ve been exposed and you are currently unvaccinated, your doctor may choose to give you an MMR vaccine or a medicine called immune globulin, which can help reduce your chances of developing full-blown measles if administered shortly after exposure.

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How to boost immunity even further.

To ensure you’re adequately protected against measles, and to help develop the “herd immunity” that’s so important for keeping communities safe, most experts would say vaccination is key. But if you’ve already been vaccinated, that doesn’t mean you shouldn’t take additional steps to reduce your likelihood of catching the virus—especially if your immune system is compromised.

“You are more likely to catch a virus such as measles if you are immune compromised in any way, which can include being on immunosuppressive drugs such as those used for autoimmune diseases like rheumatoid arthritis and Crohn's disease,” says Heather Moday, M.D., integrative immunologist. If this sounds like you, it’s best to steer clear of places where you’re likely to be exposed to measles. You can also bolster your system by eating a nutrient-dense diet with plenty of vitamin A. “Nutrient deficiencies including low vitamin A may play a role because [this vitamin] is important for maintaining mucosal immunity,” says Moday. “The precursor to vitamin A is beta-carotene. So eating plenty of beta-carotene-rich fruits and veggies such as carrots, squash, yams, and kale is helpful.”

Bottom line: Measles is one of the most (if not the most) contagious diseases that we know of, so you don’t want to mess around. But taking the recommended steps above can help keep you safe.